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Test Code LAB23 Digoxin, Plasma

Performing Laboratory

Barnes-Jewish Hospital Laboratory

Methodology

Kinetic interaction of microparticles in solution (KIMS)

Specimen Requirements

Specimen Type: Plasma
Container/Tube: Mint-green top (lithium heparin)
Specimen Volume: Full tube

Collection Instructions: Draw specimen no earlier than 60 minutes prior to dose. Absorption is complete by 8 hours, therefore, a specimen drawn 8 or more hours after the last dose is acceptable.

 

Additional Information: 

  1. Endogenous substances such as DLIF (Digoxin-like immunoreactive factors) may interfere with this assay by yielding slightly elevated results. DLIF are observed primarily in samples from neonates, pregnant women, and acute care patients with renal or hepatic failure.
  2. The manufacturer of Digoxin Immune Fab (Antibody fragment therapy) has stated that no immunoassay technique is suitable for quantitating Digoxin in serum from patients undergoing this treatment.

Day(s) Test Set Up

Monday through Sunday

Turnaround Time:
STAT: 1 hour after receipt in laboratory 
Routine: 2-4 hours after receipt in laboratory

Test Classification and CPT Coding

80162

Reference Values

Therapeutic concentration: 0.5-1.2 ng/mL

Critical result (automatic call-back): ≥2.4 ng/mL

 

The therapeutic range for digoxin varies by indication:

Heart failure: 0.5 to 0.8 ng/mL.

Atrial fibrillation: less than 1.2 ng/mL.

Toxicity: >2.4.

Normal or low digoxin does not rule out toxicity.

Current interpretive data was last revised on 09/01/2024.

 

 

Literature References:

  • Package Insert: Digoxin DIG. Roche Corporation 02/2012.    
  • The Digitalis Investigation Group. The effect of digoxin on mortality and morbidity in patients with heart failure. N. Engl. J. Med. 336: 525-532 (1997).
  • Ahmed A, Pitt B, Rahimtoola SH, Waagstein F, White M, Love TE, Braunwald E. Effects of digoxin at low serum concentrations on mortality and hospitalization in heart failure: a propensity-matched study of the DIG trial. Int. J. Cardiol. 123: 138-46 (2008).
  • Goldberger ZD, Goldberger AL. Therapeutic ranges of serum digoxin concentrations in patients with heart failure. Am. J. Cardiol. 109: 1818-1821 (2012).

Specimen Transport Temperature

Ambient

Additional Information

For BJH Laboratory Use Only
Alternate Tube:

1 dark green-top (lithium or sodium heparin) tube

1 red-top tube

1 lavender-top (EDTA) tube
Separator gel tube is acceptable

 

Analyte Stability:

  • Specimens must be processed within 4 hours.
  • Processed sample stability:
    • Ambient - 24 hours
    • Refrigerated (2 - 8°C) - 2 days
    • Frozen (≤ -20°C) - 6 months
  • See Analyte Stability Chart below in Special Instructions for a complete list.

Laboratory Processing Instructions:

Test performed in BJH Core Lab.  Processed by automated line for delivery to the Cobas 8000. Completed specimens are stored refrigerated for 5 days. 

Special Instructions

LOINC Code Information

Name LOINC Code
Digoxin, Plasma 10535-3